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NPI Code Detail

MEDICARE: MS. SHAWNTA FITZPATRICK P.A.-C

MEDICARE: MS. SHAWNTA FITZPATRICK P.A.-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA030272DC
2363A00000XPhysician AssistantC0002574MD
3363A00000XPhysician Assistant0110001741VA

General Provider Information

NPI Number : 1497750061
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHAWNTA FITZPATRICK P.A.-C
Provider Business Mailing Address
First Line : 712 OGLETHORPE ST NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20011-2735
Country : US
Telephone Number : 301-839-1600
Fax Number : 301-749-0027
Provider Business Practice Location Address
First Line : 6144 OXON HILL RD
Second Line :
City : OXON HILL
State : MD
Zip : 20745-3107
Country : US
Telephone Number : 301-839-1600
Fax Number : 301-749-0027
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 07/08/2007

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Directions to “ MS. SHAWNTA FITZPATRICK P.A.-C” Practice Location

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